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Forecasting effects...
Forecasting effects of "fast-tracks" for surgery in the Swedish national guidelines for distal radius fractures
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- Schmidt, Viktor (author)
- Umeå University,Umeå universitet,Ortopedi,Umeå Univ, Dept Surg & Perioperat Sci Orthoped, Umeå, Sweden.
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- Mellstrand Navarro, Cecilia (author)
- Karolinska Institute,Karolinska Institutet,Stockholm South General Hospital
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- Ottosson, Markus (author)
- Umeå University,Umeå universitet,Ortopedi,Umeå Univ, Dept Surg & Perioperat Sci Orthoped, Umeå, Sweden.
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- Tägil, Magnus (author)
- Lund University,Lunds universitet,Building Bone Killing Bugs,Forskargrupper vid Lunds universitet,Klinisk och experimentell benläkning,Lund University Research Groups,Clinical and experimental bone healing
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- Christersson, Albert (author)
- Uppsala University,Uppsala universitet,Ortopedi
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- Engquist, Markus (author)
- Department of Orthopedics, Ryhov Hospital, Jönköping, Sweden,Ryhov Hosp, Dept Orthoped, Jönköping, Sweden.,Ryhov County Hospital, Jönköping
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- Sayed-Noor, Arkan (author)
- Karolinska Institute,Stockholm South General Hospital
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- Mukka, Sebastian (author)
- Umeå University,Umeå universitet,Ortopedi,Umeå Univ, Dept Surg & Perioperat Sci Orthoped, Umeå, Sweden.
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- Wadsten, Mats (author)
- Umeå University,Umeå universitet,Ortopedi,Umeå Univ, Dept Surg & Perioperat Sci Orthoped, Umeå, Sweden.
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(creator_code:org_t)
- 2022-02-10
- 2022
- English.
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 17:2
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Abstract
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- BACKGROUND AND PURPOSE: National guidelines for treatment of distal radius fractures (DRFs) were presented in Sweden in 2021. In the guidelines, a fast-track is recommended for 4 subgroups of highly unstable DRFs. Regardless of the results of the closed reduction these are recommended for surgery within 1 week of injury. This study aims to evaluate the potential consequences of the newly presented national guidelines on incidence of surgical interventions.PATIENTS AND METHODS: In all, 1,609 patients (1,635 DRFs) with primary radiographs after a DRF between 2014 and 2017 at two Swedish hospitals were included in a retrospective cohort study. An estimation was made of the percentage of patients in the historical pre-guidelines cohort, that would have been recommended early primary surgery according to the new national guidelines compared to treatment implemented without the support of these guidelines.RESULTS: On a strict radiological basis, 32% (516 out of 1635) of DRFs were classified into one of the 4 defined subgroups. At 9-13 days follow-up, cast treatment was converted into delayed primary surgery in 201 cases. Out of these, 56% (112 out of 201) fulfilled the fast-track criteria and would with the new guidelines have been subject to early primary surgery.INTERPRETATION: The fast-track regimen in the new guidelines, has a high likelihood of identifying the unstable fractures benefitting from early primary surgery. If the proposed Swedish national guidelines for DRF treatment are implemented, a greater proportion of fractures would be treated with early primary surgery, and a delayed surgery avoided in the majority of cases. The potential benefits in relation to possible costs when using the fast-track criteria in every day practice are still unknown.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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